Employment Type: Full time Shift: Evening Shift Description: At Saint Alphonsus Health System, we are looking for people who are living out their calling. We want you to be passionate about coming to work, and challenged to achieve your potential. Living by these virtues, we pride ourselves on exceptional service and the highest quality of care. As a Patient Access Specialist, you will play a significant part in creating a great experience for patients and their families! You will verify patient identification, demographic information and insurance information. You'll also enter patient information in the hospital information system, refer patients with questions regarding financial liability to the available resources, and provide estimates for out of pocket costs. Our ideal candidate has the ability to multitask in a busy environment while making quick decisions independently. He or she will need to utilize excellent communication skills while communicating with patients and families and other colleagues. You will also need to be able to set and organize your own work priorities. The ability to provide superior customer service will be essential in this position. GENERAL SUMMARY AND PURPOSE: Greets patients and family members, obtains, and verifies demographic, clinical, financial, and insurance information during the (pre)-registration process, accepts point of service payments or provides guidance for payment options, and clears the patient for service delivery. SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE: High school diploma or equivalent required. Associate degree in Accounting or Business Administration preferred. Prior work experience performing customer service activities within a hospital or clinic environment, an insurance company, managed care organization or other health care financial setting preferred. Knowledge of insurance and governmental programs, regulations and billing processes and/or managed care contracts and coordination of benefits preferred. ESSENTIAL FUNCTIONS: Knows, understands, incorporates, and demonstrates the Organization's Mission, Vision, and Values in behaviors, practices, and decisions. Verifies patient identification, demographic information, and insurance coverage. Accepts point of service payments. Enters patient information accurately into appropriate hospital information system(s). Refers patients with questions regarding financial liability to appropriate resource(s). Accepts medical authorization or referral forms, if appropriate. Processes key documents to facilitate obtaining insurance information. Provides payment estimates for out of pocket costs. Educates patients/families on the use of registration kiosks or online systems. Identifies routine issues and escalates to Supervisor, Patient Access. Processes insurance claim forms. Reviews claims/accounts for complete information, corrects and completes forms to ensure accuracy. Accesses information and translates data into information acceptable to the claims processing system. Prepares claims for return to provider/subscriber if additional information is needed. Maintains all appropriate claim files and follows up on suspended or outstanding claims. Identifies, researches, and resolves issues related to coordination of benefits, subrogation, and general inquiry issues, then communicates the results. Identifies routine payer or provider issues and escalates to Lead Patient Financial Services Representative. Acts as a point of contact for assigned payers. Maintains compliance with HIPAA and other regulatory requirements throughout all activities. Protects the safety of patient information by verifying patient identity to preserve the integrity of the patient record and ensures all records are complete, accurate, and unique to one patient. Performs pre-registration, insurance verification and financial clearance activities in a variety of settings and for multiple patient types. Communicates frequently with patients/family members/guarantors, and physicians or their office staff in the deployment of key activities. Colleagues of Saint Alphonsus Health System enjoy competitive compensation with a full benefits package and opportunity for growth throughout SAHS and Trinity Health! Visit www.saintalphonsus.org/careers to learn more about the benefits, culture, and career development opportunities available to you at Saint Alphonsus Health System. Visit Saint Alphonsus on LinkedIn, Facebook, Instagram, YouTube, and Twitter! Saint Alphonsus and Trinity Health are committed to promoting diversity in its workforce and to providing an inclusive work environment where everyone is treated with fairness, dignity and respect. We are committed to recruit and retain a diverse staff reflective of the communities we serve. Saint Alphonsus and Trinity Health are equal opportunity employers and prohibit discrimination against any individual with regard to race, color, religion, gender, marital status, national origin, age, disability, sexual orientation, or any other characteristic protected by law. Our Commitment to Diversity and Inclusion Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law. Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs. For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.